Role of Health Technology Assessment
Assessment in Health Care, SBU Technology means Health Technology
The equipment, devices and drugs, andthe medical and surgical proceduresused in prevention, diagnosis, treatment,and rehabilitation. Health Technology Assessment The process of HTA
A systematic review of thescientific literature
Countries with agencies/institutions for HTA A selection of completed assessments by SBU Working days lost due to Strikes/lockouts Working days lost due to Strikes/lockouts Sickness absence Methods used in treatment of back pain Number of studies on back pain Grading of evidence Strong evidence– consistent findings in two
or several scientific studies of high quality. Moderate evidence– consistent findings in two
or several scientific studies of acceptable quality. Limited evidence– only one study available
or inconsistent findings in several studies. No evidence– no study of acceptable scientific Low Back Pain Low Back Pain Technologies used in the diagnosis of back and neck pain Economic impact of evidence-based treatment for back pain Alcohol and drug abuse
– There are effective measures available for
prevention, however, these are under-used. Methods used in the treatment of alcohol- and drug abuse with no support of scientific evidence Non-manual based therapies: Preoperative routines
There is no evidence of benefit to the patient,nor to the surgeon or the anaesthesiologist,to perform routine examinations beforeelective surgery on otherwise healthypatients. Bone density measurement
There are no scientific basis for recommendingbone density measurement in mass screening,selective screening, or as an extra componentin health check-ups of asymptomaticindividuals (opportunistic screening). Instead:
– Smoking– Low physical activity– Lack of oestrogen / calcium
Screening for prostate cancer
The scientific evidence shows thatthere are no compelling reasons torecommend neither mass screeningnor opportunistic screening forprostate cancer
A selection of current SBU-projects
• Prevention and treatment of obesity• Prevention and treatment of osteoporosis• Prevention of caries• Treatment of depression• Anxiety• Dementia• Chronic pain• Venous thrombosis• Hearing impairment• Treatment by sick-leave• Prevention of disease by physical activity
SBU Alert A selection among >50 assessments of emerging technologies
• Antiplatelet agents – clopidogrel• Brachytherapy for prostate cancer• BNCT – Radiotherapy with neutrons for brain tumors• Bupropion in smoking cessation• Cardiac Pumps in treating chronic heart failure• Gene therapy• Growth hormone in children with idiopathic short status• Implantable defibrillators• Screening for colorectal cancer• Testosterone therapy in men with age-related hormone
HTA within the EU The ECHTA/ECAHI HTA EUROPE EUR-ASSESS
Totally over 100 people are involved in the project.
– Clearinghouse function– Emerging technologies
Recommendations to EU
The European Commission should put in place a
sustainable and properly funded support function for aEuropean Union-wide network on assessment of healthinterventions and technology.
This network should involve recognized organisations and
agencies in the field of HTA, which will enable and facilitatethe coordination of assessment within the European Union.
The Commission will thereby demonstrate the benefits of
these activities and the risks of not implementing them interms of quality of life, quality of care, and cost of healthcare. Challenge
”I swear by Apol o, the physician,and invoking all the Gods andGoddesses to be my witnesses thataccording to my ability and judgement
and evidence based information from HTA studies
I will keep this oath and stipulation.”
Best Practice & Research Clinical GastroenterologyIstituto Allergologico Lombardo, Piazza Monsignor Moneta 1, 20090 Cesano Boscone, Milan, ItalyS.C. Allergology and Clinical Immunology, Niguarda ‘Ca’ Granda’ Hospital, Piazza Ospedale Maggiore, 3, 20162 Milan, ItalyAdverse reactions to foods, aside from those considered toxic, are caused by a particularindividual intolerance toward
Recently, a case has come before the Honourable Alastair Nicholson, Chief Justice of the Family Court in Australia, in the judge authorized that a 13 year-old child with a condition known as gender identity dysophoria (GID) receive treatment as part of a sex Here, sexologist and CASE faculty member, Dr Patricia Weerakoon, comments on the Alex is a classic case of “Gender Identity Dysphor